Bryan Christopher Blacker, MD | |
5409 Avenue O Ste 121, Fort Madison, IA 52627-9673 | |
(319) 372-5437 | |
(319) 376-2719 |
Full Name | Bryan Christopher Blacker |
---|---|
Gender | Male |
Speciality | Pediatrics |
Location | 5409 Avenue O Ste 121, Fort Madison, Iowa |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1528590189 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | MD-47016 (Iowa) | Primary |
Entity Name | Southeast Iowa Regional Medical Center Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1164433884 PECOS PAC ID: 3870496417 Enrollment ID: O20040130000139 |
Entity Name | Fort Madison Community Hospital |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1083764393 PECOS PAC ID: 8729971841 Enrollment ID: O20040203001066 |
Mailing Address | Practice Location Address |
---|---|
Bryan Christopher Blacker, MD 1501 Indian School Rd Ne Apt D105, Albuquerque, NM 87102-1641 Ph: (505) 377-2773 | Bryan Christopher Blacker, MD 5409 Avenue O Ste 121, Fort Madison, IA 52627-9673 Ph: (319) 372-5437 |
Gregory F Gorski, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 5409 Avenue O, Fort Madison, IA 52627 Phone: 319-376-2134 Fax: 319-376-2188 | |
Kolleen Burnett, Pediatrics Medicare: Medicare Enrolled Practice Location: 5409 Avenue O, Fort Madison, IA 52627 Phone: 319-376-2134 Fax: 319-376-2188 | |
Curt C. Mcclellan, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 5409 Avenue O, Po Box 174, Fort Madison, IA 52627 Phone: 319-376-2134 Fax: 319-376-2188 | |
Susan E Teggatz, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 5409 Avenue O, Suite 1, Fort Madison, IA 52627 Phone: 319-376-2134 Fax: 319-376-2188 |